Tag Archives: Separation Anxiety

Separation Anxiety And The Insecure Child

When I was twelve years old I went on a French exchange with my school. This involved me staying with a French family for a fortnight. Although they were all perfectly nice people (from what I could make out from my extremely limited ability to communicate with them) I became extremely homesick (even though my home life was very unhappy, but such is the paradoxical nature of the condition) and cried everyday, insisting I telephoned my mother. The parents of my French exchange partner were very tolerant,and, despite the cost, permitted me to do this uncomplainingly.

Then, when I was seventeen (I was now living with my father and step-mother), I was due to go on an American exchange trip ( this time for a whole month) but developed a mysterious fever a couple of days before I was due to go which was serious enough for my doctor to instruct me that I would be unable to travel.

Developing physical illness as a child in response to anticipated or actual separation from home is a classic symptom of a childhood psychiatric condition known as separation anxiety.

Before I talk about this condition more generally, here is one last example of how I manifested this form of anxiety as a very young child (long before the two examples given above occurred). Apparently, if I was out walking (or, in my case, toddling) with my mother and it was windy, I would become very frightened, hysterically so, in fact, that I would be physically blown away and would hold onto my mother’s (frigid) hand as if my very life depended upon it. This represents another classic example of separation anxiety.

Above: How I might have looked being carried off by the wind as a toddler and my mother’s likely obliviousness to the fact.

I have other examples, but these three will, I think, suffice for now.

How Common Is Separation Anxiety?

Separation anxiety is the most prevalent type of childhood anxiety condition (other types include obsessive-compulsive disorder, phobia, social anxiety and generalised anxiety disorder).

Approximately 1 in 20 children will suffer from it at any given time and females are more likely to be affected by it than males, all else being equal. The disorder is most likely to manifest itself when the child is between about 7 and 9 years of age but can also develop in children as young as 2 years old as well as in adolescents as old as seventeen years (myself being a case in point).

What Causes Separation Anxiety?

The condition can occur in response to traumatic, early childhood experiences such as the mother not being reliably available (physically, emotionally or both) during the child’s babyhood. Also, it can manifest itself after a major traumatic family event such as parental divorce or life-threatening illness of a parent. Also, if a child is emotionally insecure and feels deprived of love, attention and protection, the condition is also much more likely to develop. Finally, it is likely that certain genetic and biological factors can make a child more susceptible to the adverse effects of early stressors like those described and, therefore, such a child is at increased risk.

How Is Separation Anxiety Diagnosed?

As the name of the condition suggests, a child who suffers from it displays severe anxiety if s/he has to separate from his/ her primary care-giver for a period of time (or anticipates having to do so). For a formal diagnosis (and that can only be made by a properly qualified and experienced professional) the level of anxiety the disorder gives rise to in the child must cause him/her significant distress. A further stipulation for a formal diagnosis is that symptoms of the condition must have been present for a minimum time period of 4 weeks.

What Specific Symptoms Can Separation Anxiety Produce?

A child who is suffering from separation anxiety may:

– exhibit extreme homesickness when away from home

– refuse to be left alone in a room

– refuse to sleep in a room alone

– suffer nightmares that centre around themes of abandonment, rejection and separation from caregivers

– exhibit extreme distress when separated from primary caregivers or when anticipating such separation

– refuse to go to school

– continually follow the primary caregiver around the house

– exhibit fear of primary caregivers dying or becoming seriously ill even when they are perfectly healthy

– display a constant need to know where parents are

– become extremely distressed if primary caregivers are late arriving home

Separation anxiety can only be diagnosed and treated by appropriately qualified and experienced professionals. Available treatments include cognitive behavioral therapy and certain medications. In the UK, the first port of call is likely to be a GP or school psychologist/ counselor.

I have already written at length about the fact that those of us who suffered significant childhood trauma are more likely to suffer anxiety disorders as adults than those who had a relatively stable upbringing (all else being equal).

Anxiety disorders are very common. In any one year in the U.S. about eighteen per cent of individuals will be diagnosed with one of these disorders. Many more will suffer from excessive worry which has not been diagnosed.

In this article, I want to look at the main different types of anxiety disorder that exist.

First, however, it is worth pointing out that some anxiety is healthy. For example, many of us would be anxious before an important job interview, and, in such a case, a moderate amount of anxiety can improve our performance (e.g. it might compel us to prepare thoroughly). Such ‘healthy’ anxiety is appropriate and transient (i.e. it disperses soon after the stressful event is over and does not impair our functioning).

However, if a person is constantly, unremittingly, extremely anxious, on a day-to-day basis, and this anxiety has an adverse effect upon his/her thinking and behaviour, it is quite possible s/he is suffering from a diagnosable anxiety disorder.

Let’s take a look at the various types of anxiety disorder that exist :

1) SEPARATION ANXIETY : this involves the individual becoming excessively anxious about being separated from those with whom s/he has formed a significant attachment. It is more common in children and can often derive from a disrupted bonding process which took place between the baby and mother (or other primary care-giver). The symptoms the child is likely to display if suffering from separation anxiety include excessive crying and tantrums.

Adults and adolescents suffering from the condition are more likely to express it by displaying signs of acute panic as well as developing physical symptoms such as headaches and nausea.

If exposed to the dreaded object or situation, the individual will respond with extreme fear and anxiety.

Another hallmark of the condition is that the affected person will go to extreme lengths to avoid the feared object or situation in a manner which can be highly disruptive to his/her life.

3) SELECTIVE MUTISM : the individual affected by this disorder ceases to speak in certain social situations (though NOT in all social situations). The very thought of having to speak in these particular situations leads to the experiencing of great distress and panic. It is most common in children and it is far more extreme than ordinary shyness.

4) PANIC DISORDER : an individual who suffers from this will experience an intense, sudden onset of fear and anxiety which causes significant distress and symptoms such as chest pain, rapidly beating heart, shaking, dizziness, nausea and even a feeling of very imminent death.

Sometimes, there are triggers which give rise to such reactions, whereas, at other times, the distressing feelings may materialize ‘out of the blue’.

In either case, the person will feel a desperate need to escape the current situation in which s/he finds him/herself.

However, this reaction alone (which psychologists refer to as a ‘panic attack‘) is insufficient to warrant a diagnosis of panic DISORDER – for this condition to be diagnosed, the person must not only suffer from panic attacks, but, ALSO, must be so PREOCCUPIED with concern about their possible occurrence that his/her life is significantly disrupted.

One of the most common fears that people with panic disorder have is of entering largerdepartment stores, supermarkets etc.

Not infrequently, those who suffer from panic disorder feel safer if, in the feared situation, they have someone with them to provide them with reassurance.

5) AGORAPHOBIA : this condition involves an irrational and disproportionate fear of PARTICULAR situations. In such feared situations, they will experience intense concern that something terrible will happen which they will be unable to escape.

Therefore, the individual will desperately avoid exposing themselves to the feared situation in a way that significantly impairs their daily functioning. (e.g. being unable to travel to a place of work due to an irrational fear of public transport).

6) SOCIAL ANXIETY DISORDER : this condition involves a deep fear of being judged and negatively evaluated in certain social situations. Such situations cause the person to experience an extremely uncomfortable level of anxiety and distress which tenaciously persists.

In this way, the condition significantly impairs day-to-day functioning.

Often, it is NOT ALL social situations which give rise to such anxiety in the sufferer, but, rather, specific ones such as meeting new people or interacting in large groups.

7) GENERALIZED ANXIETY DISORDER (GAD) : this condition manifests itself by causing the sufferer to worry obsessively about a WIDE VARIETY of concerns (both important and trivial) in a way which is very hard to control, and, therefore, often overwhelming.

The level of anxiety is so high that it significantly disrupts the individual’s life.

The condition can impair, for example :

– the ability to concentrate

– the ability to hold down a job

– the ability to sleep

The individual may be so consumed by worry that s/he feels trapped in an internal world of pain and detached from the outside world.

For the disorder to be formally diagnosed, the condition must be experienced more days than not and the level of worry must be significantly disproportionate to its source in reasonable and objective terms.

Other symptoms may include :

– irritability

– fatigue

– nausea

– headaches

– stomach complaints.

CONCLUSION :

As I stated at the start of this article, because many anxiety conditions may have their root in our experience of childhood trauma that has caused the resultant anxiety to be shifted onto our ‘thinking style’, leading to us perceiving the world as dangerous, and ourselves to as powerless, helpless and highly vulnerable, therapies which address this ‘faulty thinking style’, such as cognitive behavioural therapy (CBT), can be highly effective at correcting and, consequently, at reducing, our anxiety levels (click here to read my article on how CBT can help us to recover from childhood trauma).